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931: Advanced Principles of Anesthesia I > Final exam Review > Flashcards

Final exam Review Flashcards

1
Q

Indications for cervical plexus block include

A

carotid endartectomy, clavicle fracture, superficial neck surgery

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2
Q

The major nerves of the cervical plexus include

A

greater auricle, lessor occipital, supraclavicular, transverse cervical nerve, phrenic nerve

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3
Q

If the patient is not able to “pull” this describes appropriate blocking of the

A

musculocutaneous nerve

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4
Q

The nerves of the brachial plexus are in the tightest bundle at the

A

supraclavicular level

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5
Q

Injury to the _____- & ____ can occur with interscalene block

A

dorsal scapular & long thoracic nerve

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6
Q

Lipid emulsion dosing is

A

1.5 mL/kg

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7
Q

The quadratus lumborum targets the

A

ilioninguinal & iliohypogastric nerves

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8
Q

The lumbar plexus supplies sensory & motor innervation to

A

the thigh, anterolateral knee, & sensory innervation to the medial aspect of the lower extremity below the knee

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9
Q

The femoral triangle includes:

A

medial aspect of sartorius, medial aspect of adductor longus, & inguinal ligament

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10
Q

Landmark technique for the sciatic (subgluteal block)

A

greater trochanter & ischial tuberosity

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11
Q

Landmark for the iPack block includes

A

the posterior capsule & the popliteal fossa

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12
Q

Labs for myomectomy include

A

T&C & H&H

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13
Q

A total hysterectomy involves removal of

A

uterus & cervix

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14
Q

Hemabate is contraindicated for

A

asthmatics

methergine should not be given for those with hypertension

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15
Q

Cervidil will

A

ripen the cervix

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16
Q

Normal GFR is

A

125 mL/min.

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17
Q

ADH works in the

A

distal tubule to reabsorb water

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18
Q

General anesthesia is associated with a decrease in

A

renal blood flow, GFR, urinary flow, electrolyte secretion, & impairs autoregulation

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19
Q

S/s of fluoride toxicity include

A

hypernatremia & increased creatinine

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20
Q

CKD exists when

A

GFR is less than 60 mL/min.

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21
Q

Risk factors for AKI include

A

age >50 years, cardiac comorbidities & AAA

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22
Q

Symptoms of CKD do not appear until

A

less than 40% of normal functioning nephrons remain `

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23
Q

The most common cause of death for patients with CKD is

A

ischemic heart disease

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24
Q

Treatment for hyperkalemia includes

A

25-50 grams of dextrose, 10-20 units of regular insulin, 50-100 mEq for sodium bicarbonate

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25
The most reliable test for renal function is
creatine clearance
26
Glycine toxicity can cause
transient blindness
27
Complications of TURP are related to
water intoxication, fluid overload, & hyponatremia
28
Most important prevention for TURP is
to avoid Tendelenburg position
29
The spinal cord ends at
L1-L2 in adults & L3 in children
30
When added to a spinal, clonidine
is not a vasoconstrictor & has synergistic effects, can help with tourniquet pain
31
Fiber types include
``` type b- preganglionic autonomic type C- pain, warm, could, & touch Type A- alpha- proprioception, motor Type A beta- touch, pressure Type A gamma- muscle tone Type A delta- pain, cold, temperature & touch ```
32
33 bones of the spinal column include
``` 7 cervical 12 thoracic 5 lumbar 5 sacral 5 coccyx ```
33
Total CSF volume in an adults is
150 mL, produce 21 mL/hour, SAH holds 20-35 mL
34
The phrenic nerve is _____ the anterior scalene
anterior
35
If both recurrent laryngeal nerve paralyzed then cords will be
paramedian | if vagus is paralyzed then cadaveric position
36
Disadvantages to regional block include
hypotension & unpredictable success rate
37
Uvulopalatopharyngoplasty enlarges airway through removal of
soft palate, palatine tonsils, & uvula
38
____ is more soluble than air, helium, oxygen, or nitrous
CO2
39
IAP
15 mmHg
40
Physiologic changes of pneumoperitneum include
increased PaCO2, EtCO2, & decreased VR
41
Sphincter of Oddi spasm can be treated with
glucagon
42
Pickwickian syndrome is a
severe chronic OSA leading to cor pulmonale
43
Describe how biventricular failure develops in obese patients.
increased total blood volume, increased CO, increased RAAS, increased left-side heart pressures & LVH
44
Anesthetic considerations for spinal surgeries include
visual loss, bleeding, VAE
45
BCIS symptoms include
hypotension & hypoxemia & heart block
46
Pneumatic tourniquet should not be used for more than
2 hours
47
Fat embolism s/s include
petechia, hypoxemia, & pulmonary edema
48
The two branches of the vertebral artery include
the anterior spinal artery & posterior spinal arteries
49
6 extraocular muscles of the eye include:
superior rectus- supraduction- CN III inferior rectus- infraduction- CN III medial rectus- adduction- CN III lateral rectus- abduction- CN VI superior oblique- intorsion, depression-CN IV inferior oblique- extorsion, elevation- CN III
50
Describe the oculocardiac reflex.
the nerve that carries signal to the brain for the reflex is the trigeminal nerve the vagus sends back out to cause bradycardia--> stop pulling on the muscle, give atropine or glycopyrrolate
51
What's unique about the optic nerve?
part of the CNS- outgrowth of the brain | it is not a cranial nerve & so the meninges surround it
52
Intraocular pressure measures
measures the pressure of the eye & is formed by aqueous humor normal pressure is 12-20 mmHg someone with glaucoma will have higher intraocular pressure
53
The following medications can be administered to bring intraocular pressure down:
diamox- contraindications include sulfa allergy & liver/kidney dysfunction mannitol
54
The branches of the trigeminal nerve include
ophthalmic, maxillary, & mandibular
55
The facial nerve includes
the zebra bit my cousin paul anterior: temporal, zygomatic, buccal & mandibular inferior: cervical posterior: posterior auricular
56
Fire triad includes
oxidizer fuel source ignition source
57
TTJV is
rapid, small volume ventilation be mindful of expiratory time pressure you're ventilating at is 60 psi
58
Most common complication of plastics is
DVT & PE
59
______ presents the highest risk for morbidity & mortality in plastic surgery
liposuction
60
The FDA max dose of lidocaine is
35 mg/kg
61
Considerations for burns include:
concern for airway edema- check cuff leak may have to suture ETT keep the room warm aseptic paralytic dosages- don't use succinylcholine, requires higher doses of NMDRs very painful so give opioids
62
Endpoints for burn surgeries include
>3 hours, >10 units of blood, <35 degrees
63
Nerves most often monitored in ENT surgery include
facial, vagus, recurrent & superior laryngeal nerve, & spinal accessory nerve
64
Tonsil surgery considerations include:
rebleeding into the stomach, RSI, bad PONV, want an H&H if they rebleed
65
Endoscopic sinus surgery considerations include
controlled hypotension dural puncture positioning-rotated away with arm tucked
66
With sentinel lymph node biopsy,
axillary nerve monitoring is being performed so you can't paralyze
67
When dye is injected for masectomy
pulse ox can drop | allergic reaction to dyes
68
If a patient is having a DIEP flap
avoid vasopressors specifically pheylephrine b/c microvasculature
69
For ambulatory surgery
6 months for labs if no change no routine preop testing cheaper to do surgery here
70
Disadvantages of ambulatory surgery include
less time monitoring for complications have to transfer for higher level care have to coordinate PT/OT don't have set preop-decreased privacy
71
Perioperative complications most commonly occur in
20-49 year olds
72
Appropriate patients for ambulatory surgery include
ASA 1 or 2, no known difficult airway, should be at baseline health status
73
Need ____ bottles of dantrolene
36 vials | dose 2.5 mg/kg
74
Damage to dorsal scapular produces
atrophy & weakness of the rhomboid
75
Spinal cord specific gravity is
1.003-1.009
76
Hyperbaric will
settle in the thoracic if you lay them flat
77
For epidural anesthesia, ____ determines block density
concentration determines density and volume determines spread
78
Bupivacaine is cardiotoxic because
it is highly protein bound & it sticks around
79
Benefits for laparoscopic surgery include
early mobilization less pain less blood loss
80
Disadvantages for laparoscopic surgery include
``` decreased visualization PONV retained gas with shoulder pain- Toradol crepitus subcutaneous emphysema ```
81
Obesity types include gynecoid & android
android is worse because it is around the heart
82
In obese patients, lung volumes are
decreased & all capacities are decreased as well
83
Fat emboli will present as
SOB petechiae fat globules in urine

931: Advanced Principles of Anesthesia I (22 decks)

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